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General NPI Number Information
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NPI Number | 1275806929
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Entity Type | Organization
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Legal Business Name | TML VISION CARE, LLC
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Dates
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Enumeration Date | 02/10/2012
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Last Update Date | 02/10/2012
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Provider Practice Location Address
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Address Line | 154 ROUTE 10 UNIT B
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City | EAST HANOVER
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State | NJ
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Zip | 07936
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Country | US
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Telephone | 973-248-1188
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Fax |
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Provider Business Mailing Address
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Address Line | 92 ROUTE 23 NORTH SUITE E
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City | RIVERDALE
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State | NJ
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Zip | 07457
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Country | US
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Telephone | 973-248-1188
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. EMMA MUTZ
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Credential |
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Telephone | 973-248-1188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 31TD00305000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 31TD00352000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00594600
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License Number State | NJ
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